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Tennessee rates for HCPCS 15260

Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$677.09 / $1,828.10 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.29 / $921.15 / $1,422.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.62 / $1,064.21 / $1,301.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,610.00 / $2,800.00 / $3,710.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$787.31 / $1,051.29 / $1,610.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$785.45 / $1,082.47 / $2,489.87
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,837.34 / $5,952.36 / $16,394.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,182.00 / $7,291.36 / $8,430.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,130.00 / $2,297.00 / $4,099.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$874.27 / $1,096.98 / $2,204.98